• Title/Summary/Keyword: joint loss

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Treatment of Diabetic Charcot Arthropathy (당뇨병성 샤콧 관절의 치료)

  • Chung, Hyung-Jin
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.4
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    • pp.243-250
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    • 2013
  • Diabetic Charcot arthropathy is a severe joint disease in the foot and ankle that can result in fracture, permanent deformity, limb loss. Although recent research has improved our level of knowledge regarding its etiology and treatment, it still remains a poorly understood disease. It is a serious and potentially limb-threatening lower-extremity late complication of diabetes mellitus and its diagnosis is commonly missed upon initial presentation. Clinicians treating diabetic patients should be vigilant in recognizing early signs of acute Charcot arthropathy, such as pain, warmth, edema, or pathologic fracture in a neuropathic foot. Early detection and prompt treatment can prevent joint and bone destruction. If left untreated, it can reduce overall quality of life and dramatically increase morbidity and mortality of patients. The goal of this manuscript is to evaluate the current concepts of Charcot arthropathy through review of various literature and help clinicians decide the treatment strategy.

Laser Micro-Joining and Soldering (레이저 마이크로 접합 및 솔더링)

  • Hwang, Seung Jun;Kang, Hye Jun;Kim, Jeng O;Jung, Jae Pil
    • Journal of the Microelectronics and Packaging Society
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    • v.26 no.3
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    • pp.7-13
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    • 2019
  • In this paper, the principles, types and characteristics of the laser and laser soldering are introduced. Laser soldering methods for electronics, metals, semiconductors are also presented. Laser soldering is a non-contact process that transfers energy to solder joint by a precisely controlled beam. Demands for laser soldering are increasing due to bonding for complex circuits and local heating in micro joint. Laser absorption ratio depends on materials, and each material has different absorption or reflectivity of the laser beam, which requires fine adjustment of the laser beam. Laser types and operating conditions are also important factors for laser soldering performance. In this paper, the performance of Nd:YAG laser soldering is compared to the hot blast reflow. Meanwhile, a diode laser gives different wavelength and smaller parts with high performance, but it has various reliability issues such as heat loss, high power, and cooling technology. These issues need to be improved in the future, and further studies for laser micro-joining and soldering are required.

Prism Compressive Strength of Non-structural Concrete Brick Masonry Walls According to Workmanship (시공정밀도에 따른 비구조용 콘크리트벽돌 조적벽체의 프리즘 압축강도)

  • Shin, Dong-Hyeon;Kim, Hyung-Joon
    • Journal of the Architectural Institute of Korea Structure & Construction
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    • v.36 no.2
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    • pp.127-136
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    • 2020
  • Prism compressive strength is the most influential parameter to evaluate the seismic performance of non-structural concrete brick masonry walls, and is affected by the practice and workmanship of masonry workers. This study experimentally investigates the influence of workmanship on prism compressive strength throughout the compressive test with prism specimens constructed according to masonry workmanship. To do this, the workmanship is categorized into good, fair, and poor conditions which are statistically evaluated with thickness and indentation depth of bed-joints. Then, the effect of workmanship on the structural properties of masonry prisms is evaluated by investigating relations between properties such as their compressive strength, elastic modulus and numerical parameters such as thickness, filling of bed-joints. This study demonstrates that the indentation depth is more important parameter for structural properties of masonry prisms and masonry prisms with loss in bed-joint area less than of 7% can be in fair condition.

The humeral suspension technique: a novel operation for deltoid paralysis

  • de Joode, Stijn GCJ;Walbeehm, Ralf;Schotanus, Martijn GM;van Nie, Ferry A;van Rhijn, Lodewijk W;Samijo, Steven K
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.240-243
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    • 2022
  • Isolated deltoid paralysis is a rare pathology that can occur after axillary nerve injury due to shoulder trauma or infection. This condition leads to loss of deltoid function that can cause glenohumeral instability and inferior subluxation, resulting in rotator cuff muscle fatigue and pain. To establish dynamic glenohumeral stability, a novel technique was invented. Humeral suspension is achieved using a double button implant with non-resorbable high strength cords between the acromion and humeral head. This novel technique was used in two patients with isolated deltoid paralysis due to axillary nerve injury. The results indicate that the humeral suspension technique is a method that supports centralizing the humeral head and simultaneously dynamically stabilizes the glenohumeral joint. This approach yielded high patient satisfaction and reduced pain. Glenohumeral alignment was improved and remained intact 5 years postoperative. The humeral suspension technique is a promising surgical method for subluxated glenohumeral joint instability due to isolated deltoid paralysis.

Analysis of beam-column joints reinforced with SMAs under monotonous loading with existence of transverse beam

  • Halahla, Abdulsamee M.;Tahnat, Yazan B. Abu;Dwaikat, Monther B.
    • Earthquakes and Structures
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    • v.22 no.3
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    • pp.231-243
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    • 2022
  • Beam-column joints (BCJs) are recognized among the most crucial zones in reinforced concrete structures, as they are the critical elements subjected to a complex state of forces during a severe earthquake. Under such conditions, BCJs exhibit behaviors with impacts that extend to the whole structure and significantly influence its ductility and capability of dissipating energy. The focus of this paper is to investigate the effect of undamaged transverse beam (secondary beams) on the ductility of concrete BCJs reinforced with conventional steel and shape memory alloys bars using pushover analysis at tip of beam under different axial load levels at the column using a nonlinear finite element model in ABAQUS environment. A numerical model of a BCJ was constructed and the analysis outcomes were verified by comparing them to those obtained from previous experiments found in the literature. The comparison evidenced the capability of the calibrated model to predict the load capacity response of the joint. Results proved the ability of undamaged secondary beams to provide a noticeable improvement to the ductility of reinforced concrete joints, with a very negligible loss in load capacity. However, the effect of secondary beams can become less significant if the beams are damaged due to seismic effects. In addition, the axial load was found to significantly enhance the performance of BCJs, where the increase in axial load magnified the capacity of the joint. However, higher values of axial load resulted in greater initial stiffness of the BCJ.

Factors Associated with Dizziness in Korean Adults (한국 성인의 어지럼 경험과 관련 요인)

  • Seo, Yeong-Mi;Lee, Eun Sook
    • Journal of muscle and joint health
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    • v.31 no.1
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    • pp.53-63
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    • 2024
  • Purpose: This study aimed to determine the prevalence of dizziness in adults and to identify factors associated with dizziness. Methods: This cross-sectional study used secondary data from the Eighth Korea National Health and Nutrition Examination Survey. Participants included 10,265 older adults aged≥40 years. Data were analyzed using descriptive statistics, the chi-squared test, and multinomial logistic regression with the SPSS/WIN 27.0 program. Results: The prevalence of dizziness was 26.2%, with 20.9% reporting episodic dizziness and 5.3% reporting chronic dizziness. Compared to that noted in the control group participants without dizziness, the risk of episodic or chronic dizziness was higher in women and in participants with older age, low education level, low income level, high perceived stress level, depression, tinnitus, and occupational noise exposure. Moreover, the risk of chronic dizziness was higher among those with a body mass index of <25 kg/m2, stroke, cardiovascular disease, or severe hearing loss. Conclusion: The study underscores the need to comprehensively identify risk factors associated with dizziness and to develop interventions to prevent and manage the occurrence and chronicity of dizziness in the general population.

Klebsiella pneumoniae and Enterobacter cloacae Induced Septic Arthritis in a Healthy Adolescent: A Rare Case Report

  • Reza Zandi;Shahin Talebi;Shirin Sheibani;Akbar Ehsani
    • Hip & pelvis
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    • v.34 no.3
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    • pp.185-190
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    • 2022
  • Septic arthritis (SA) is a joint inflammation that develops secondary to infectious causes. SA in children is associated with a high rate of morbidity and mortality; therefore, it is regarded as an orthopedic emergency. Because SA of the hip joint usually mimics other musculoskeletal diseases, diagnosis remains challenging. Although this lesion usually shows a good outcome, treatment at an inappropriate time, neglect, or inadequate treatment could lead to poor outcomes. We report on the case of a healthy adolescent who complained of episodes of fever and chills, weight loss, pain in his left hip, and limping. After performing necessary workups, two differential diagnoses of tumor and SA were made. The results of Gram stain and culture of the synovial fluid after surgical excision showed Klebsiella pneumoniae and Enterobacter cloacae complex. To the best of our knowledge, this is the first report of SA due to co-infection with K. pneumoniae and E. cloacae in a healthy patient.

Long-term clinical and radiographic outcomes of arthroscopic acromioclavicular stabilization for acute acromioclavicular joint dislocation

  • Eduard Van Eecke;Bernard Struelens;Stijn Muermans
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.219-228
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    • 2024
  • Background: Standard open acromioclavicular (AC) stabilization is associated with increased postoperative complications including deltoid injury, infection, tunnel complications, loss of reduction, and wound/cosmetic concerns. Arthroscopy may offer superior visualization and advantages that limit these risks. The aim of this prospective non-randomized study is to evaluate advantages and long-term reliability of arthroscopic AC stabilization. Methods: Thirty-two patients with acute grade III, IV and V AC dislocations underwent arthroscopic AC reconstruction with long-term assessment by clinical AC examination, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, visual analog scale, Specific AC Score and Quick Disabilities of the Arm, Shoulder and Hand scores. Radiographs verified conservation of initial reduction and presence of coracoclavicular (CC) ossifications. Complications, revision rate, and satisfaction were assessed and compared to the literature. Results: Mean follow-up time was 67.6 months. All clinical outcome scores improved and differences were statistically significant (P<0.001). Initial postoperative radiographs consistently showed complete reduction. Two patients experienced relapse to grade II AC dislocation without clinical implications. In total, 71.8% showed CC ossifications without functional impairment, and in 31.3% concomitant injuries were observed. Reintervention rate was 9.4%, and 96.9% of patients were satisfied with procedure outcomes. Conclusions: Arthroscopic stabilization for acute AC joint dislocations offers satisfactory clinical and radiographic outcomes, and our results show that the arthroscopic technique is reliable in the long run. We report better reduction in maintenance, fewer complications, and similar reoperation rates compared to other techniques.

Reduction Loss after Extension Block Kirschner Wire Fixation for Treatment of Bony Mallet Finger (골성 추지 신전제한 K 강선 고정술 시행 후 정복소실)

  • Kim, Byungsung;Nho, Jae-Hwi;Jung, Ki Jin;Yun, Keonhee;Park, Eunseok;Park, Sungyong
    • Archives of Hand and Microsurgery
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    • v.23 no.4
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    • pp.239-247
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    • 2018
  • Purpose: We investigated occurrence of reduction loss after extension block (EB) Kirschner wire fixation or additional interfragmentary fixation (AIF) and clinical results including extension lag of the distal interphalangeal joint for treating bony mallet finger. Methods: Forty-six patients were included with a mean follow-up of 28 months (range, 12-54 months). Twenty-seven patients were treated with EB K-wire fixation (Group A) while 19 patients were treated with AIF (Group B). We checked radiologic factors, such as amount of articular involvement, volar subluxation, mallet fragment angle, reduction loss, range of motion including extension lag, and functional outcomes using Crawford's criteria. Results: Reduction loss occurred in eight patients (17%). Differences in mean extension lag, age, preoperative volar subluxation and mallet fragment angle between patients with reduction loss and those with reduction maintaining were significant. However, there were no significant differences in gender, hand dominance, amount of articular involvement, AIF, or further flexion between reduction loss and reduction maintaining. As for patterns of displacement, there was a significant relationship between gap or step-off and extension lag. Using Crawford's evaluation criteria, functional outcomes were excellent in 31, good in 10, fair in 3, and poor in 2 patients. Conclusion: Reduction loss should be careful in older age, smaller mallet fragment angle and preoperative volar subluxation.

A Case of Pressure Sore in Congenital Insensitivity to Pain with Anhidrosis (CIPA(Congenital Insensitivity to Pain with Anhidrosis)를 가진 환아에서 욕창의 치험례)

  • Hwang, Jae Ha;Park, Sun Hyung;Yoo, Sung In;Noh, Bok Kyun;Kim, Eui Sik;Kim, Kwang Seog;Lee, Sam Yong
    • Archives of Plastic Surgery
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    • v.33 no.5
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    • pp.669-671
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    • 2006
  • Purpose: Congenital insensitivity to pain with anhidrosis(CIPA) is a rare form of autosomal recessive peripheral sensory neuropathy. Patients with CIPA show loss of pain sensation, which leads to corneal ulcers and opacities, self-mutilation of the tongue and fingertips, as well as fractures with subsequent joint deformities and chronic osteomyelitis. The purpose of this report is to highlight the fact that pressure sores also are a potential complication of CIPA. Methods: This case report describes a patient presenting with pressure sores resulting from CIPA. A 5-year-old boy was referred to our department for the treatment of a $5{\times}5cm$ sacral pressure sore as a result of a hip spica cast applied for the treatment of a left hip joint dislocation. He had a history suggesting CIPA such as multiple bony fractures, mental retardation, recurrent hyperpyrexia, anhidrosis, and clubbing fingers due to oral mutilation. A microscopic examination of the sural nerve showed mainly large myelinated fibers, a few small myelinated fibers and an almost complete loss of unmyelinated fibers. After wound preparation for two weeks, the exposed bone was covered with two local advancement flaps. Results: Two weeks later, complete wound healing was achieved. A 16-month follow-up showed no recurrence. However, the patient presented with a new pressure sore on the left knee due to orthosis for the treatment of the left hip joint dislocation. Conclusion: The early diagnosis of CIPA and special care of pressure sores are important for preventing and treating pressure sores resulting from CIPA.